Wheelchair and seating assistive technology provision: a gateway to freedom

The meaning of wheelchair and seating assistive technology and the impact inappropriate provision has on people’s lives from a service user’s perspective within an Irish context is highlighted. There is a dearth in evidence examining the process of wheelchair and seating provision and the interconnectedness between satisfaction, performance and participation from an equality and human rights perspective. The purpose if the study is to investigate wheelchair service users’ perspectives of wheelchair and seating provision in Ireland.
This is a mixed-methods study with an exploratory sequential design that includes two phases. During phase one, wheelchair service users were invited to take part in qualitative in-depth semi-structured interviews, which were thematically analysed and formed part of a larger ethnographic study involving multiple stakeholders in sustainable wheelchair and seating provision strategy development. In phase two, an online Survey Monkey questionnaire was distributed to obtain a wider overview of wheelchair service provision from a wheelchair service users perspective. Data obtained from the closed questions and content analysis for open comments was analysed descriptively for this phase.
Eight wheelchair service users agreed to participate in the interviews and 273 responded to the online survey. Thematic analysis and questionnaire frequency and content analysis revealed the vital meaning of wheelchair and seating assistive technology provision. However, bottlenecks within the system affect daily living, with qualitative data highlighting the obstruction to experiences of independent living from initial appointment to wheelchair breakdowns during daily life.
Appropriate wheelchair and seating assistive technology provision is a basic human right, supported by the essential and embodied nature of the wheelchair as demonstrated through the wheelchair service users’ perspective throughout this study. These findings highlight the impact of ad-hoc services on individual freedoms and how the overall pace of the system affects a person’s ability to organise their time as an equal member of the community across the lifespan. A national review of wheelchair and seating assistive technology provision services is called for, giving consideration to access to services, assessment and delivery, follow up and management, education and training.IMPLICATIONS FOR REHABILITATION
Wheelchair and seating assistive technology provision as a basic human right is misunderstood.
Appropriate wheelchair and seating assistive technology provision should be provided to meet this primary need as a pre-requisite for survival.
Every aspect of the wheelchair and seating provision process impacts on occupational performance, equality of opportunity and community mobility.
Wheelchair and seating assistive technology professionals and providers have a responsibility to review their practice and service provision systems.

Wheelchair and seating assistive technology provision as a basic human right is misunderstood.
Appropriate wheelchair and seating assistive technology provision should be provided to meet this primary need as a pre-requisite for survival.
Every aspect of the wheelchair and seating provision process impacts on occupational performance, equality of opportunity and community mobility.
Wheelchair and seating assistive technology professionals and providers have a responsibility to review their practice and service provision systems.

本研究着重阐述了爱尔兰语境下，服务使用者视角中的轮椅与坐姿辅助辅具（wheelchair and seating assistive technology）的内涵，以及适配不当的辅具供给对其生活造成的影响。目前，从平等与人权视角出发，探究轮椅与坐姿辅具供给流程、满意度、作业表现与参与度之间内在关联的实证研究仍较为匮乏。本研究旨在调查爱尔兰地区轮椅服务使用者对轮椅与坐姿辅具供给的看法。
本研究采用探索性序列设计的混合研究方法，分为两个阶段。第一阶段，邀请轮椅服务使用者参与质性深度半结构化访谈，对访谈资料进行主题分析，且该部分研究属于一项涵盖可持续轮椅与坐姿辅具供给战略制定相关多方利益相关者的大型民族志研究的组成部分。第二阶段，通过分发SurveyMonkey在线问卷，从轮椅服务使用者视角更全面地了解轮椅服务供给情况。本阶段对封闭式问题数据及开放式评论的内容分析结果均采用描述性统计方法进行分析。
共有8名轮椅服务使用者同意参与访谈，另有273人回复了在线问卷。主题分析、问卷频数分析及内容分析结果显示，轮椅与坐姿辅助辅具的供给具有至关重要的意义。然而，现有体系中的诸多瓶颈严重影响了使用者的日常生活，质性资料更清晰地揭示了从初次预约到日常使用中轮椅故障期间，独立生活体验所遭遇的重重阻碍。
本研究通过轮椅服务使用者的视角证实，轮椅具有本质性且具身性的属性，因此适配得当的轮椅与坐姿辅助辅具供给是一项基本人权。本研究结果凸显了临时应急服务对个体自由的影响，以及体系整体运作节奏如何影响个体作为社区平等成员、贯穿整个生命周期的时间规划能力。研究呼吁对轮椅与坐姿辅助辅具供给服务开展全国性审查，需涵盖服务可及性、评估与交付、后续跟进与管理、教育培训等方面。
## 康复领域的启示
轮椅与坐姿辅助辅具供给作为一项基本人权的理念仍存在认知误区。
应提供适配得当的轮椅与坐姿辅助辅具，以满足这一关乎生存的核心需求。
轮椅与坐姿辅具供给流程的每个环节，都会对作业表现、机会平等及社区出行能力产生影响。
轮椅与坐姿辅助辅具相关专业人员及服务机构有责任审视自身的执业行为与服务供给体系。

轮椅与坐姿辅助辅具供给作为一项基本人权的理念仍存在认知误区。
应提供适配得当的轮椅与坐姿辅助辅具，以满足这一关乎生存的核心需求。
轮椅与坐姿辅具供给流程的每个环节，都会对作业表现、机会平等及社区出行能力产生影响。
轮椅与坐姿辅助辅具相关专业人员及服务机构有责任审视自身的执业行为与服务供给体系。